成人t -急性淋巴细胞白血病的免疫表型特征及治疗效果伊拉克中心的经历

IF 1.6 Q3 HEMATOLOGY

Hematology, Transfusion and Cell Therapy Pub Date : 2025-07-01 DOI:10.1016/j.htct.2025.103882

Abdulsalam Al-Ani , Alaadin Sahham Naji , Luma Essa Hamodi , Alaa Fadhil Alwan

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引用次数: 0

摘要

目的约25%的急性淋巴母细胞白血病（Acute Lymphoblastic Leukemia， ALL）表达t细胞抗原，被认为是高危人群的预测因子。本研究旨在了解伊拉克青年和成年患者的t细胞急性淋巴细胞白血病（T-ALL）的免疫表型特征。同时，确定治疗结果与免疫表型和治疗方案的关系。本研究使用巴格达医疗城中央流式细胞术科2019年1月7日至2020年5月3日的实验室数据进行。免疫表型记录显示35例青少年和成人患者（14岁或以上）患有T-ALL。患者分为早期（未成熟）t细胞前体（ETP）和成熟t细胞前体（MTP）。根据患者的年龄、性别和免疫表型表达与所使用的治疗类型的相关性进行了评估。结果确诊T-ALL患者35例，平均年龄28.1±12.3岁，男性占74.3%。根据白血病t细胞成熟阶段对患者进行分层，成熟表型（皮质和髓质）比未成熟表型更常见（68.6%对31.4%）。MTP标志物的表达率在老年患者中有统计学意义。20岁（p = 0.03）或男性（p = 0.01）。大多数患者采用hyperCVAD 26（74.3%）方案，其余患者采用UKALL（25.7%）方案。82.9%的患者缓解，11.4%的患者无效，8.7%的患者在诱导期间死亡。在5个月的中位随访中，54.3%的患者维持缓解，11.4%的患者复发。1年的总生存期（OAS）为55%，平均生存期为13.8+1.7个月，与治疗类型、t细胞亚型和髓系抗原表达无关。尽管与hypervad相比，UKALL组的缓解率更高，死亡率更低，但差异无统计学意义（p = 0.81）。与ETP谱系相比，MTP谱系更好的反应是唯一具有显著意义的结果（p = 0.045）。结论t - all多见于男性。超过一半的患者维持了缓解，MTP患者比ETP患者有更好的反应和生存。结果不受年龄、性别或治疗方案的影响。

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IMMUNOPHENOTYPIC CHARACTERISTICS AND TREATMENT OUTCOME OF T-ACUTE LYMPHOBLASTIC LEUKEMIA IN ADULTS; AN IRAQI CENTER EXPERIENCE

Objective

About 25% of Acute Lymphoblastic Leukemia (ALL) express T-cell antigens which being considered a predictive of high-risk group. This study was conducted to find out the immunophenotypic characteristics of T-cell Acute Lymphoblastic Leukemia (T-ALL) in young and adult Iraqi patients. Also, to determine the association of treatment outcome with the immunophenotype and the treatment regimen used.

Methodology

The study was conducted using the laboratory data of the Central Flowcytometry Department at Baghdad Medical City between 7 January 2019 and 3 May 2020. The immunophenotypic records revealed 35 young and adult patients (age of 14-year or older) with T-ALL. The patients were classified into early (immature) T-cell Precursor (ETP) and Mature T-cell Precursor (MTP). Correlation of the patients’ outcome according to age, gender, and immunophenotypic expressions with the type of therapy used were evaluated.

Results

Thirty-five patients were diagnosed with T-ALL with a mean age of 28.1±12.3, and 74.3% were males. The stratification of patients according to the stage of leukemic T-cells maturation showed more frequent mature phenotype (cortical and medullary) than the immature (68.6% vs. 31.4%). The MTP markers expression showed a statistically significant higher rate in patients aged < 20-year (p = 0.03) or male (p = 0.01). Most patients received hyperCVAD 26 (74.3%) protocol, and UKALL was administered in the remaining (25.7%). Remission was achieved in 82.9%, while 11.4% failed to respond and 8.7% died during induction. Remission was maintained in 54.3% with 5-months of median follow-up, and relapse was found in 11.4%. The Overall Survival (OAS) at one year was 55%, with a mean survival of 13.8+1.7 months without an association with the type of therapy, subtype of T-cell, and myeloid antigenic expression. Despite a higher remission rate and lower death rate among UKALL group compared to HyperCVAD, the difference is non-significant (p = 0.81). The better response of MTP compared to ETP lineage was the only significant value with the outcome (p = 0.045).

Conclusion

T-ALL is more commonly encountered in males. Remission was maintained in more than half of the patients with a better response and survival of the patients with MTP than those with the ETP subtype. The outcome was not affected by age, gender, or the treatment protocol.

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